This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Systemic Sclerosis (SSc) is an autoimmune disease that affects 1:17,000 persons. The major cause of death in SSc is pulmonary involvement, with patients developing pulmonary hypertension or pulmonary fibrosis, both resulting in respiratory failure. Patients with this disease also can experience problems with arthritis, muscles, swallowing, the stomach and intestines, the kidney and the heart. The disease can be painful and debilitating and can lead to premature death. There is no cure for Scleroderma and current treatment is usually aimed at treating the symptoms. The clinical course and organ involvement in Scleroderma can be variable, so what is a complication in one patient may not occur in another. The objective of the current study is to study environmental, behavioral, cultural, genetic and laboratory factors in a cohort of Scleroderma patients with early disease, in order to identify trends, and risk factors for serious complications of the disease. These factors will be studied in Caucasian, African American and Hispanic populations who have been diagnosed less than five years. It will be important to identify patients at high risk for developing serious complications of Scleroderma so that treatment can be modified to impact on their disease.